Learning About Lipedema

Lipedema is an abnormal buildup of fat in certain body parts. Almost all cases occur in women. It affects about 1 in 10 women worldwide. It’s especially common in those between puberty and age 30.

As lipedema gets worse, it can cause pain, fatigue, and the breakdown of joints. This can make it harder to move and live an independent life.

The exact cause is unknown. But most experts believe it’s caused by a mix of:

• Genetics (family history).
• Hormone changes (puberty, pregnancy, menopause).
• Metabolism (how the body turns food into energy).
• Inflammation (how the body responds to injury or infection).

It's also linked to (but not caused by) being overweight or having obesity.

There are five types. For each type, a part of the body has more fat than the rest of the body.

• Type 1: There's more fat in the thighs, hips, and buttocks.
• Type 2: There's more fat from the thighs to the knees.
• Type 3: There's more fat from the thighs to the ankles.
• Type 4: There's more fat in the arms.
• Type 5: There's more fat from the knees to the ankles.

Types 1, 2, and 3 are most common.

Signs and symptoms may include:

• A buildup of fat in the legs, hips, buttocks, or arms.
• The same buildup of fat on both sides of the body.
• No fat buildup in the feet and hands, which can look like an ankle or wrist “cuff.”
• Fat that doesn't go away with diet, exercise, or surgery.
• Pain, tenderness, and heaviness in affected areas.
• Fatigue.
• Starting or worsening at times of hormonal changes.
• Easy bruising.
• Firm, hard lumps under the skin.
• Swelling.
• Loose joints.

It’s diagnosed with a physical exam and a patient history. You will be asked about your symptoms. But because many doctors aren't familiar with it, it's often confused with other conditions. These include lymphedema, obesity, and venous insufficiency. This could lead to treatments that may not work.

It’s important to know what's unique about lipedema. For example, pain, tenderness, and bruising are common only with lipedema. Also, unlike the other conditions, lipedema usually doesn’t get better with diet and exercise.

Doctors may use a Stemmer sign test to tell if you have lymphedema or lipedema. Lymphedema is a collection of fluid called lymph in the tissues of the body. The test involves pinching the skin at the base of the second toe. If the skin lifts easily, lymphedema is not likely. If the skin doesn’t lift easily, it is likely lymphedema. Imaging can also show lymphedema.

There is no cure and few treatment options for lipedema. This can be hard to accept, so mental health support can be helpful.

But some symptoms can improve with strength training, fitness, and diet. You may feel better, and lipedema may not get worse. This is mainly true for milder cases. But the fat buildup won't go away.

You can wear compression socks or arm sleeves to help with swelling. This can improve blood flow and help with other issues.

Talk to your doctor about surgery. It may be an option for some people. Liposuction can help with movement, pain, swelling, and physical appearance. This can improve your quality of life. Often more than one surgery is needed.